SUSAN K FATA Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049177992

License Status

NOT RENEWED

Business

First Name

SUSAN

Middle

Last Name

FATA

Business Name

SUSAN K FATA

Original Issue Date

07/24/2007

Effective Date

01/12/2010

Expiration Date

03/31/2011

City

NORMAL

State

Zip

61761

County

MCLEAN

Ever Disciplined

LastModifiedDate

05/12/2011